A Virginia man who killed a hospital security guard and a sheriff’s deputy after escaping from custody in 2006 has been executed after an unsuccessful campaign to spare the inmate’s life over concerns about his mental health.

William Morva, 35, was pronounced dead at 9.15pm on Thursday after a lethal injection at Greensville correctional center in Jarratt. It was the first execution in Virginia under a new protocol that makes more of the lethal injection procedure secret.

Virginia set to execute man using 'potentially torturous' drug cocktail

The lethal injection began about 9pm after the warden read him the court order of his execution. Shortly after the drugs began flowing, his stomach moved up and down quickly several times before he became motionless.

Morva’s execution came hours after Virginia’s Democratic governor announced he would not spare Morva’s life despite pressure from mental health advocates, state lawmakers and attorneys who said the man’s crimes were the result of a severe mental illness that made it impossible for him to distinguish between delusions and reality.

In denying a clemency petition, Governor Terry McAuliffe concluded Morva received a fair trial. He noted that experts who evaluated the man at the time found he didn’t suffer from any illness that would have prevented him from understanding the consequences of his crimes. He also said prison staff members who monitored Morva for the past nine years never reported any evidence of a severe mental illness or delusional disorder.

Terry McAuliffe, Virginia governor said “I personally oppose the death penalty; however, I took an oath to uphold the laws of this Commonwealth regardless of my personal views of those laws, as long as they are being fairly and justly applied.”

Morva was the first inmate executed in Virginia since officials made changes to the state’s protocol that have drawn fire from attorneys and transparency advocates. Those changes came after attorneys raised concerns in January about how long it took to place an IV line during the execution of convicted killer Ricky Gray.

Execution witnesses used to be able to watch inmates walk in and be strapped down. A curtain would then be drawn during the placement of the IV and heart monitors. After the curtain was reopened, inmates would be asked whether they had any final words before the chemicals started to flow.

In Morva’s execution, the curtain was closed when the witnesses entered the chamber and was not opened until he was strapped to the gurney and the IV lines were in place. Virginia used a three-drug mixture, including midazolam and potassium chloride that it obtained from a compounding pharmacy whose identity remains secret under state law.

Morva is the third inmate to be executed since McAuliffe took office in 2014. In April, McAuliffe granted clemency to Ivan Teleguz, saying jurors in the murder-for-hire case were given false information that may have swayed sentencing.

Among those who had urged McAuliffe to spare Morva’s life were the daughter of the slain sheriff’s deputy, two United Nations human rights experts, and representatives from the Hungarian embassy. Morva’s father was born in Hungary and Morva was a Hungarian-American dual national.

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“Our message and William’s story and his family’s story were resonating with a lot of people, and I don’t know why it didn’t resonate with the governor,” Morva’s attorney Dawn Davison said after the execution.

Morva was awaiting trial on attempted robbery charges in 2005 when he was taken to the hospital to treat an injury. There, he attacked a sheriff’s deputy with a metal toilet roll holder, stole the deputy’s firearm, and shot an unarmed security guard, Derrick McFarland, in the face before fleeing. A day later, Morva killed another sheriff’s deputy Eric Sutphin with a bullet to the back of the head as Sutphin searched for him near Virginia Tech’s Blacksburg campus.

Experts who examined Morva for his trial said he suffered from personality disorders that resulted in “odd beliefs”.

After his trial, a psychiatrist diagnosed him with delusional disorder, a more severe mental illness akin to schizophrenia that made him falsely believe, among other things, that he has life-threatening gastrointestinal issues and that a former presidential administration conspired with police to imprison him, his attorneys said.

His lawyers argued Morva escaped and killed the men because he was under the delusion that he was going to die in jail.